Profile of Hypertensive Emergencies in a Tertiary Care Hospital, Chennai

Rajkumar, P (2020) Profile of Hypertensive Emergencies in a Tertiary Care Hospital, Chennai. Masters thesis, Kilpauk Medical College, Chennai.

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Abstract

INTRODUCTION: A hypertensive crisis is classified as hypertensive emergency (HTN-E) or hypertensive urgency (HTN-U). HTN-E is characterized by a severe elevation of blood pressure SBP>180 and/or DBP >120 with evidence of progressive organ damage or target organ failure. HTN-U is defined as SBP>180 and/or DBP >120 without failure or damage to the target organ. AIM OF THE STUDY: To study the clinical presentation of hypertensive emergencies related to Cardiovascular, Neurological and Reno vascular system. OBJECTIVES: 1. Various causes of HTN-E are studied. 2. Assessment of Target organ damage in HTN-E. 3. Assess Retinopathy by direct ophthalmoscope and proportionate them based on grading. 4. Assess cardiovascular system damage which includes LVH, IHD, Acute LVF, AMI using ECG, ECHO, Chest - ray. 5. Assess Central Nervous system damage which includes TIA, Intracerebral bleed, cerebral infarction, encephalopathy clinically and using CT/MRI Brain (if needed). Assess Renal involvement based on USG, RFT, Renal artery Doppler if needed and finally proportionate them based on multiple target organ damage. METHODOLOGY: Among the patients admitted with hypertensive crisis those who are Pregnant, Diabetes Mellitus, already diagnosed as end organ damage In Kilpauk Medical College 105 patients were evaluated for end organ damage in relation to cardiovascular system, central nervous system, Reno vascular system and Retinopathy. LIMITATIONS OF THE STUDY: Only a small number of population is taken for the study. So little space for robust statistical analysis. This is a hospital based study and hence it may not be the representative of the general population. Study population restricted to patients referred to our department so a selection bias may have influenced the results. Inability to use research design like higher level of blinding due to paucity of time and resources Alternate causes and medication effects influencing the parameters analyzed should also be considered. CONCLUSIONS: Majority of the patients presenting with hypertensive emergencies Belonged to fourth and fifth decade of life, were males, Were smokers, Had no alcohol intake, Had good drug compliance, Had giddiness, dyspnea, visual disturbances and psychomotor agitations. On investigations mainly had LVH, cardiomegaly and altered CMD, Mainly presented with grade 2 retinopathy, Mainly presented with stage 4 and 5 nephropathy, Mainly presented with cerebral Infarct. Mainly presented with acute LVH, Majority had multiple organ damage – especially two and above. Most common organ involvement in patients was the cardiovascular system followed by central nervous system, renal and retina.

Item Type: Thesis (Masters)
Additional Information: 201711161
Uncontrolled Keywords: Profile of Hypertensive Emergencies, Tertiary Care Hospital, Chennai.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 28 Jan 2021 16:59
Last Modified: 28 Jan 2021 16:59
URI: http://repository-tnmgrmu.ac.in/id/eprint/13272

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